title: Length of hospital stay with patient-dependent determination in bilateral scheduled staged total knee arthroplasty.
abstract: OBJECTIVE
  The purpose of this study was to approach the length of hospital stay (LOS) by patient-dependent determination and evaluate the effect of contralateral total knee arthroplasty (TKA) on LOS in patients with bilateral osteoarthritis undergoing staged bilateral TKAs.
  
  
  METHODS
  One hundred sixty TKAs in 80 patients with bilateral osteoarthritis were evaluated by retrospective review of their medical records. All patients had scheduled staged bilateral TKA. We investigated the length of hospital stay in each TKA and the postoperative day when patients could perform walking and climbing up and down the stairs with one cane independently. Range of motion in each knee was also evaluated in preoperatively and before discharge. The median interval between the first and second surgeries was 12 months.
  
  
  RESULTS
  The first and second TKAs showed a median LOS of 37 and 35 days, respectively, with no significant difference (n.s.). The median number of days before independently walking and climbing up and down the stairs with one cane were 8 and 16 after the first TKA and 7 and 15 after the second TKA, respectively, without significant differences (n.s. for walking, n.s. for stairs).
  
  
  CONCLUSIONS
  An initial TKA that results in good function might neither facilitate an earlier second rehabilitation nor decrease the LOS. Taking other factors such economics and local conditions that largely influence LOS into account, simultaneous bilateral TKAs might be an effective treatment for bilateral knee arthritis in properly selected patients in terms of decreasing the LOS.
authors.affiliation: Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan, ishii@sakitama.or.jp.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishii
authors.forename: Hideo
authors.initials: H
authors.lastname: Noguchi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takeda
authors.forename: Junko
authors.initials: J
authors.lastname: Sato
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000534:rehabilitation; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007564:Japan; D007719:Knee Joint / Q000502:physiology*; D007902:Length of Stay; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016138:Walking / Q000502:physiology